Eduard Rindfleisch (1836-1908)

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Eduard Rindfleisch (1836-1908)

Postby cheerleader » Fri Oct 02, 2009 11:06 am

Dr. Eliott Frohman spoke of Dr. Rindfleisch and his theory of venous congestion in Bologna, and I finally got around to reading some of his observations of MS brains.

Further insight into the pathophysiology of MS was provided by Eduard Rindfleisch, a 19th century German pathologist, who analysed post-mortem brain samples from MS patients.

In 1863, Rindfleisch reported a key finding that paved the way for theories of inflammatory involvement in the aetiology of MS. He noticed that, consistently in all the specimens, a blood vessel was present at the centre of each lesion. His illustrations of the plaques are seen in the slide.

Rindfleisch wrote:
"If one looks carefully at freshly altered parts of the white matter ... one perceives already with the naked eye a red point or line in the middle of each individual focus,.. the lumen of a small vessel engorged with blood ... All this leads us to search for the primary cause of the disease in an alteration of individual vessels and their ramifications; All vessels running inside the foci, but also those which traverse the immediately surrounding but still intact parenchyma are in a state characteristic of chronic inflammation." [/b]


http://www.ms-society.ie/pages/eduard-rindfleisch/

He looked at MS brains with a microscope, and could see that inside each lesion was a vein engorged with blood. He believed the primary cause of MS was whatever altered those vessels. It has taken 140 years to look at the jugular veins as the source of venous congestion, even after all we know about venous congestion in other organs of the body. I'm sorry, but why the hell has it taken so long?

cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
User avatar
cheerleader
Family Elder
 
Posts: 5094
Joined: Mon Sep 10, 2007 2:00 pm
Location: southern California

Advertisement

Postby Arcee » Fri Oct 02, 2009 12:26 pm

It really is a remarkable story. Or 'mind-boggling' as Dr. Dake says (apparently without irony).
One way I look at it is that this is a classic battle of 'jurisdictional control,' meaning different professions have been and continue to jostle to define what their work is and who gets to do it. (And in the meantime, that 'work,' treating a certain kind of patient, has suffered.)
So for patients with certain symptoms, is the work defined as focusing on and trying to repair vessels and venous congestion or is it about doing something for hyped up autoimmune activity? And who gets to do this - - the neurologists or the vascular folks/interventional radiologists?
You can think of tons of examples, like opthamologists and optometrists, or stockbrokers and financial planners. These battles can be enduring and not pretty. The playbook is fairly predictable, and if it weren't so critically important to so many people, maybe it would feel like sport to see it play out.
Sorry for the extended riff, but it's a perspective that is near and dear to me. One lesson I have retained from my studies of this, and which so many here have been promoting, is that public opinion does play a role. So those efforts to talk nicely and broadly about CCSVI make sense even as the professional groups jostle. And as minor as it may seem, I think if we fill out medical forms by checking off the "other" box in the disease list and writing in "CCSVI," it will add to the cumulative effect.
diagnosed RR in spring '04
1 stent placed in left jugular vein 7/15/09
on and off Copaxone
allergric to interferons and Tysabri
User avatar
Arcee
Family Elder
 
Posts: 338
Joined: Wed Jan 05, 2005 3:00 pm
Location: Massachusetts, USA

Vein or Vessel?

Postby radeck » Fri Oct 02, 2009 12:30 pm

For clarification, did Rindfleisch report that all lesions were around veins (as you say, cheer), or around vessels in general. In any theory, one would expect them to be around vessels as this is where the rest of the body comes in contact with the brain. However them being around veins points to the specific theory of CCSVI.
Last edited by radeck on Fri Oct 02, 2009 1:10 pm, edited 6 times in total.
radeck
Family Elder
 
Posts: 398
Joined: Mon Feb 16, 2009 3:00 pm

Postby mrhodes40 » Fri Oct 02, 2009 12:35 pm

I'm sorry, but why the hell has it taken so long?




Ditto! Charcot wrote about the veno centric nature of the MS lesion too.

I can't help but think that the fact that what we do for MS is considered to be very sophisticated science causes us generally to have far too much faith in the findings and far to little inquisition into other new directions.

If you think about the association that Dr Zamboni originally made with venous ulcer, the open wound that occurs in feet as a result of a blocked leg vein, if no one had discovered that blockage in the vein, you can imagine that after years of looking at these sores in the feet, taking tissue samples from sores in the feet, looking under the microscope at the immune cells found, that never ever would looking at those cells 'tell' you that it was caused by the venous blockage. Furthermore if you put that person in an MRI and look at their foot lesion, and measure it and see how deep it is and test t heir blood for some kind of factor that might tell you something about the foot lesion likewise you'd be skunked. BUT you would feel very confident that you had done a lot of great science.

I just think that is the equivalent to MS lesion centric research. It can't detect something like a venous involvement because the kind of research they have done is not capable of uncovering that kind of issue, even though it is very sophisticated and high tech.

I am really glad they are on it now. They can shine that light of great science on this new area and it will be good for all of us as they find out what is going on here.
I'm not offering medical advice, I am just a patient too! Talk to your doctor about what is best for you...
http://www.thisisms.com/ftopic-7318-0.html This is my regimen thread
http://www.ccsvibook.com Read my book published by McFarland Health topics
User avatar
mrhodes40
Family Elder
 
Posts: 2066
Joined: Thu Sep 23, 2004 2:00 pm
Location: USA

Postby fernando » Fri Oct 02, 2009 12:47 pm

Image

Kuhn used the duck-rabbit optical illusion to demonstrate the way in which a paradigm shift could cause one to see the same information in an entirely different way.

Kuhnian paradigm shifts

An epistemological paradigm shift was called a scientific revolution by epistemologist and historian of science Thomas Kuhn in his book The Structure of Scientific Revolutions.

A scientific revolution occurs, according to Kuhn, when scientists encounter anomalies which cannot be explained by the universally accepted paradigm within which scientific progress has thereto been made. The paradigm, in Kuhn's view, is not simply the current theory, but the entire worldview in which it exists, and all of the implications which come with it. It is based on features of landscape of knowledge that scientists can identify around them. There are anomalies for all paradigms, Kuhn maintained, that are brushed away as acceptable levels of error, or simply ignored and not dealt with (a principal argument Kuhn uses to reject Karl Popper's model of falsifiability as the key force involved in scientific change). Rather, according to Kuhn, anomalies have various levels of significance to the practitioners of science at the time. To put it in the context of early 20th century physics, some scientists found the problems with calculating Mercury's perihelion more troubling than the Michelson-Morley experiment results, and some the other way around. Kuhn's model of scientific change differs here, and in many places, from that of the logical positivists in that it puts an enhanced emphasis on the individual humans involved as scientists, rather than abstracting science into a purely logical or philosophical venture.

When enough significant anomalies have accrued against a current paradigm, the scientific discipline is thrown into a state of crisis, according to Kuhn. During this crisis, new ideas, perhaps ones previously discarded, are tried. Eventually a new paradigm is formed, which gains its own new followers, and an intellectual "battle" takes place between the followers of the new paradigm and the hold-outs of the old paradigm. Again, for early 20th century physics, the transition between the Maxwellian electromagnetic worldview and the Einsteinian Relativistic worldview was neither instantaneous nor calm, and instead involved a protracted set of "attacks," both with empirical data as well as rhetorical or philosophical arguments, by both sides, with the Einsteinian theory winning out in the long-run. Again, the weighing of evidence and importance of new data was fit through the human sieve: some scientists found the simplicity of Einstein's equations to be most compelling, while some found them more complicated than the notion of Maxwell's aether which they banished. Some found Eddington's photographs of light bending around the sun to be compelling, some questioned their accuracy and meaning. Sometimes the convincing force is just time itself and the human toll it takes, Kuhn said, using a quote from Max Planck: "a new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it."

After a given discipline has changed from one paradigm to another, this is called, in Kuhn's terminology, a scientific revolution or a paradigm shift. It is often this final conclusion, the result of the long process, that is meant when the term paradigm shift is used colloquially: simply the (often radical) change of worldview, without reference to the specificities of Kuhn's historical argument.


http://en.wikipedia.org/wiki/Paradigm_shift
http://en.wikipedia.org/wiki/The_Structure_of_Scientific_Revolutions[/b]
User avatar
fernando
Family Elder
 
Posts: 228
Joined: Wed Jul 15, 2009 2:00 pm
Location: Argentina

Postby mrhodes40 » Fri Oct 02, 2009 1:04 pm

Cool reference Fernando and very appropriate!
I'm not offering medical advice, I am just a patient too! Talk to your doctor about what is best for you...
http://www.thisisms.com/ftopic-7318-0.html This is my regimen thread
http://www.ccsvibook.com Read my book published by McFarland Health topics
User avatar
mrhodes40
Family Elder
 
Posts: 2066
Joined: Thu Sep 23, 2004 2:00 pm
Location: USA

Postby cheerleader » Fri Oct 02, 2009 1:08 pm

radeck wrote:For clarification, did Rindfleisch report that all lesions were around veins (as you say, cheer), or around vessels in general. In any theory, one would expect them to be around vessels as this is where the rest of the body comes in contact with the brain. However them being around veins points to the specific theory of CCSVI.


He noted this in "the small veins" of the brain....it's in JT Murray's History of Multiple Sclerosis...I can't copy and paste from google books. Dr. Frohmann mentioned this as well in Bologna. We also now know that MS lesions are formed around veins-
http://www.ajnr.org/cgi/content/full/21/6/1039

But this has been know for years...for folks who haven't read Dr. FA Schelling's writings on the venous connection to MS....it's highly recommended reading:

In once more providing unmistakable pictorial evidence on the venous conditioning of cerebral multiple sclerosis, Charles E. Lumsden, in 1970, observed that in the brainstem as well multiple sclerosis-specific plaques consistently originate on veins. Specific pons lesions were accordingly shown to equally evolve as vein-dependent "Dawson-fingers" (71).
The results of Colin W. Adams' researches into the development of cerebral multiple sclerosis, on the other hand, led to a fresh realization of the fact that "the early stage of the periventricular plaque is the formation of a lesion around a subependymal vein" (1). Besides thus confirming that the changes definitively set out from veins running underneath the cerebral ventricular lining, Adams again found the lesion spread into the periphery of the cerebral hemispheres to be consistently related to the course of particular veins. The fluid inside the cerebral ventricles was accordingly not felt to play a part in the specific lesion developments (2).


http://www.ms-info.net/evo/msmanu/984
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
User avatar
cheerleader
Family Elder
 
Posts: 5094
Joined: Mon Sep 10, 2007 2:00 pm
Location: southern California

Postby mrhodes40 » Fri Oct 02, 2009 1:49 pm

Cheer mentioned that
But this has been know for years.
yes it has, and it is one of those things mentioned in Fernando's piece:

There are anomalies for all paradigms, Kuhn maintained, that are brushed away as acceptable levels of error, or simply ignored and not dealt with
I'm not offering medical advice, I am just a patient too! Talk to your doctor about what is best for you...
http://www.thisisms.com/ftopic-7318-0.html This is my regimen thread
http://www.ccsvibook.com Read my book published by McFarland Health topics
User avatar
mrhodes40
Family Elder
 
Posts: 2066
Joined: Thu Sep 23, 2004 2:00 pm
Location: USA

Postby radeck » Fri Oct 02, 2009 4:24 pm

Thank you for the clarification cheer. That is a looong time from the realization to somebody asking the "why?" question. I have yet to talk to one of my neuros about this, i.e. if there has been ANY theory other than CCSVI for why the lesions are on the vein side of the capillary system, as opposed to on the artery side.

In case of special relativity, it took physicists "only" 18 years to move from the experiment that caused the trouble until a certain person dropped the assumptions that were in the way of making sense of it, and just a couple more years until it was rather widely accepted. There wasn't much money involved.
radeck
Family Elder
 
Posts: 398
Joined: Mon Feb 16, 2009 3:00 pm

Postby cheerleader » Fri Oct 02, 2009 4:54 pm

mrhodes40 wrote:Cheer mentioned that
But this has been know for years.
yes it has, and it is one of those things mentioned in Fernando's piece:

There are anomalies for all paradigms, Kuhn maintained, that are brushed away as acceptable levels of error, or simply ignored and not dealt with



And even worse than brushing theories aside, is mocking them. In reading up on Rindfleisch I found some snarky comments about Dr. Schelling's work. The volume is called "McAlpine's Multiple Sclerosis" by Alastair Compston and Douglas McAlpine (McAlpine died in 1981, so the new version which disparages the vascular paradigm was written by Alastair Compston.) This book has been the "leading textbook" in understanding MS since the 1950s. Lord, help us.

Discusing the vascular history of MS, and how amusing it is, Compston says:

"It seems that even now this debate has not settled, leaving room for a steady stream of eccentric proposals. An Austrian doctor has made available an electronic version of his critical analysis of contemporary concepts on the aetiology of MS suggesting that the perivenous lesions are caused by a widening of venus formina in the skulls of affected individuals. We find this hypothesis less than compelling and are sparing our readers further details or advertisement of the website."


This sarcastic slight to Dr. Schelling was written in 2003. Hey.... Dr. Compston, yeah, I'm talking to you....ever wonder why Schelling saw a widening in that area upon autopsy??? Maybe because of jugular stenosis and reflux??? Did you ever try to understand his research before you brushed it off in such a cursory manner?

Oh, no??? Why? Could it be because your whole career has been based on immunogenetics? That you are too busy singing the praises of pharma and making $ with all the fabulous clinical trials you head up? Well, guess what? We didn't need you to give us the website to find Dr. Schelling's research, Dr. Compston. We don't need your book, your sarcasm or your lack of intellectual curiosity. We're done with it! And you can stick your Charcot Award where there's no vitamin D!

I'm sorry, but I'm loaded for bear. I had heard that Dr. Schelling was treated badly by neurologists, but seeing it in print really pisses me off. For those MS patients on the site, it's not about upholding your neuro's fabulous career or making them look good by taking their drugs and not progressing..(because if/when you progress, believe me, it's your problem) It's about the TRUTH!

140 years is a long time.
AC (the Angry Cheerleader)
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
User avatar
cheerleader
Family Elder
 
Posts: 5094
Joined: Mon Sep 10, 2007 2:00 pm
Location: southern California

Postby zap » Fri Oct 02, 2009 6:34 pm

My neuro is one of those who is in deep with the local MS Society, and is the continually the lead of several clinical trials of various drugs ... he dismissed CCSVI out of hand as "pseudoscience" but refused to elaborate. Ugh.
User avatar
zap
Family Elder
 
Posts: 326
Joined: Mon Apr 20, 2009 2:00 pm

Postby MrSuccess » Fri Oct 02, 2009 6:45 pm

Easy Cheer...Easy . Glad to see the fight'in side of you ...but ....

Anyway ....great research as usual !



Mr. Success
User avatar
MrSuccess
Family Elder
 
Posts: 898
Joined: Fri Sep 18, 2009 2:00 pm

Postby cheerleader » Fri Oct 02, 2009 6:55 pm

Dear Mr. Success-
You've started posting on the CCSVI forums, but never introduced yourself or divulged any personal information. Do you have MS? Are you a caretaker? What's the interest in CCSVI?
I'm sure folks would like to know.

sorry about your neuro, zap. I think pseudoscience is not knowing how or why a drug works (the mechanism of action), yet selling it to MS patients.
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
User avatar
cheerleader
Family Elder
 
Posts: 5094
Joined: Mon Sep 10, 2007 2:00 pm
Location: southern California

Postby MrSuccess » Fri Oct 02, 2009 7:39 pm

I think it's a duck ...

Cheer , you are loaded for bear tonite . And with good reason.

So I'm staying behind this big old tree until you get back in the truck!




Mr. Success
User avatar
MrSuccess
Family Elder
 
Posts: 898
Joined: Fri Sep 18, 2009 2:00 pm

Postby CureIous » Fri Oct 02, 2009 9:32 pm

MrSuccess wrote:I think it's a duck ...

Cheer , you are loaded for bear tonite . And with good reason.

So I'm staying behind this big old tree until you get back in the truck!




Mr. Success


I'm starting a time machine fund to get Cheer back into the 1800's to tell these guys how much LESS we know in 2009 lol. And to apologize on behalf of humanity for ignoring the blatantly obvious for so so long.


"Exhales collective sigh".
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
User avatar
CureIous
Family Elder
 
Posts: 1210
Joined: Tue Jul 14, 2009 2:00 pm
Location: Riverside, CA

Next

Return to Chronic Cerebrospinal Venous Insufficiency (CCSVI)

Who is online

Users browsing this forum: No registered users


Contact us | Terms of Service